Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures

• US 7,951,158 B2
• Filed: 08/03/2007
• Issued: 05/31/2011
• Est. Priority Date: 05/20/2005
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences III LLC
• Original Assignee: NeoTract, Inc. (Teleflex Incorporated)
• Inventors: Welch, Jacqueline Nerney, Nagpurkar, Amik, Collinson, Michael, Vidal, Claude, Catanese, Joseph III, Redmond, Russell J., Makower, Joshua, Walke, Amrish Jayprakash, Lamson, Theodore Charles
• Primary Examiner(s): Erezo; Darwin P
• Assistant Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/833,710
• Publication Number:
  US 20080033232A1
• Time in Patent Office: 1,397 Days
• Field of Search: 606/151, 606/153, 606/72, 606/99, 606/139, 606/213, 606/232, 604/27, 623/17.16
• US Class Current: 606/151
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• CPC Class Codes: A61B 2017/00796 Breast surgery
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 : H-fasteners
• CPC Class Codes: A61B 2017/042 : plastically deformed during insertion
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61F 2002/041 : Bile ducts

Abstract

Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues, organs, anatomical structures, grafts or other structures within the body of human or animal subjects for the purpose of treating a diseases or disorders and/or for cosmetic or reconstructive purposes and/or for research and development purposes or other purposes.

Claims

1. A device for stenting a lumen or cavity in the body of a human or animal subject, said device comprising:

an endoscope having a distal end and defining an endoscope longitudinal axis;

an elongate endoscope channel for receiving the endoscope therein;

an elongate channel substantially parallel to the endoscope channel, the elongate channel houses at least one support member prior to deployment;

an elongate structure configured to project laterally from the elongate channel, the elongate structure retaining a counteractive element;

wherein the at least one support member is positioned within the lumen or cavity or in tissue adjacent to the lumen or cavity and generally parallel to the endoscope longitudinal axis after deployment from the elongate channel, the at least one support member having a length greater than a width and including a plurality of spaced arms extending along the length; and

at least one tensioning member attached to the at least one support member at a first end and the counteractive elements at a second end, said at least one tensioning member being under sufficient tension to cause the at least one support member to stent the lumen and being generally perpendicular to the endoscope longitudinal axis after deployment;

wherein the at least one tensioning member is defined by inelastic material and the plurality of spaced arms compress the at least one tensioning member;

wherein the distal end of the endoscope is positioned to view deployment of the at least one support member.

2. A device according claim 1, wherein the at least one support member comprises an anchor that becomes anchored in or against tissue.

4. The device of claim 1, wherein the at least one support member is sized and shaped to be received within an urethra.

5. The device of claim 1, wherein the at least one support member is sized and shaped to be received within a prostate.

6. The device of claim 1, wherein the at least one support member is sized and shaped to pass through a prostate and to be placed in apposition with a prostate capsule.

10. The device of claim 1, further comprising:

a tensioning member elongate channel substantially parallel to the elongate endoscope channel, wherein the at least one tensioning member passes through the tensioning member elongate channel.

11. The device of claim 1, wherein the elongate channel has a support member opening in its side wall in a distal portion.

12. The device of claim 10, further comprising:

an actuator, wherein movement of the actuator in a proximal direction substantially parallel to the elongate channel shears the at least one tensioning member below a bottom surface of the at least one support member.

13. The device of claim 10, wherein, prior to deployment of the at least one support member and the at least one tensioning member from the device, the length of the at least one support member is substantially parallel to the elongate channel in which it is housed and the length of the at least one support member is transverse to the tensioning member.

3. A system for altering the shape of a lumen in the body of a human comprising:

an endoscope having a distal end and defining an endoscope longitudinal axis;

an elongate endoscope channel for receiving the endoscope therein;

an elongate channel substantially parallel to the elongate endoscope channel, the elongate channel houses at least one luminal communicating element prior to deployment;

an elongate structure configured to project laterally from the elongate channel, the elongate structure retaining at least one counteractive element;

wherein the at least one luminal communicating element directly or indirectly communicates force to at least one region of the lumen and is generally parallel to the endoscope longitudinal axis after deployment from the elongate channel, the luminal communicating element having a length greater than its width and including a plurality of spaced arms extending along the length;

the at least one counteractive element placed outside the lumen which is retained at one or more pre-determined locations outside the lumen; and

at least one force communicating element transmitting force between the luminal communicating element and the at least one counteractive element and being generally perpendicular to the endoscope longitudinal axis after deployment, whereby the presence of at least one of each luminal communicating element, counteractive element, and force communicating element together results in a change in the shape of the lumen;

wherein the at least one force communicating element is defined by inelastic material, the plurality of spaced arms compress the at least one force communicating element and the luminal communicating element is attached to the at least one force communicating element at or near the lumen;

wherein the distal end of the endoscope is positioned to view deployment of the luminal communicating element.

7. The system of claim 3, wherein the at least one luminal communicating element is sized and shaped to be received within an urethra.

8. The system of claim 3, wherein the at least one counteractive element is sized and shaped to be retained within a prostate.

9. The system of claim 3, wherein the at least one counteractive element is sized and shaped to pass through a prostate and be placed in apposition with a prostate capsule.

14. The system of claim 3, further comprising:

a force communicating element elongate channel substantially parallel to the endoscope channel, wherein the at least one force communicating element passes through the force communicating element elongate channel.

15. The system of claim 3, wherein the elongate channel has a luminal communicating element opening in its side wall in a distal portion.

16. The system of claim 14, further comprising:

an actuator, wherein movement of the actuator in a proximal direction substantially parallel to the elongate channel shears the at least one force communicating element below a bottom surface of the at least one luminal communicating element.

17. The system of claim 14, wherein, prior to deployment of the at least one luminal communicating element and at least one force communicating element from the device, the length of the at least one luminal communicating element is substantially parallel to the elongate channel in which it is housed and the length of the at least one luminal communicating element is transverse to the force communicating element.